Graeme Clark Collection

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    Initial results for six patients with a multiple-channel cochlear prosthesis
    Dowell, R. C. ; Brown, A. M. ; Seligman, P. M. ; Clark, Graeme M. (Monash University Press, 1983)
    A total of eight patients have been assessed with the multi-channel cochlear prosthesis at the University of Melbourne. The first two patients were implanted with a prototype device in 1978 and 1979, and their results with various speech evaluation procedures have been reported and summarized in detail elsewhere (Clark & Tong, 1982). Briefly, these results indicated that some very significant benefit could be obtained for these patients when using the cochlear prosthesis with external speech processing, particularly when using the device in conjunction with lipreading. It was also shown that some significant understanding of speech was possible without lipreading (open-set) for both patients, although this was fairly limited.
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    Speech perception, production and language results in a group of children using the 22-electrode cochlear implant
    Busby, P. A. ; Brown, A. M. ; DOWELL, RICHARD ; Rickards, Field W. ; Dawson, Pam W. ; Blamey, Peter J. ; Rowland, L.C. ; Dettman, Shani J. ; Altidis, P. M. ; Clark, Graeme M. ( 1989)
    Paper presented at the 118th Meeting of the Acoustical Society of America
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    Results of multiple-electrode cochlear implants in children
    Tong, Y. C. ; Blamey, P. J. ; Dowell, R. C. ; Nienhuys, T. G. ; Musgrave, G. N. ; Mecklenburg, D. J. ; Busby, P. A. ; Roberts, S. A. ; Dowell, R. C. ; Musgrave, G. N. ; Blamey, P. J. ( 1987)
    Children in Australia and United States of America are now being implanted with the Nucleus 22 electrode intracochlear prosthesis utilizing the F0/F1F2 coding strategy. A total of 32 adolescents (10-17 years) and 24 preadolescents (2-9 years) have been implanted as of 31 August, 1987. No significant postoperative complications were recorded, the speech processors were successfully programmed, and all are users of the device. For the 56 children, the average length of postoperative stimulation time is 2.8 months. Because the majority of children have such short experience with the device we report herein two children from the University of Melbourne (A) and two children from the United States (U) who have been using the Nucleus system for 12 months or more. Child 1A has only 10 electrodes in the cochlea; therefore, the number of channels programmed for the children is 10, 17, 18 and 18, respectively. Child Al and A2 were deafened by meningitis at 3-3 and 3 years of age, respectively. Child U3 became profoundly deafened from a progressive sensorineural loss at age 11 and Child U4 was deafened by recurrent cochlear hydrops at age 13 years.
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    Signal processing in quiet and noise
    Dowell, R. C. ; Patrick, J. F. ; Blamey, P. J. ; Seligman, P. M. ; Money, D. K. ; Clark, Graeme M. ( 1987)
    It has been shown that many profoundly deaf patients using multichannel cochlear implants are able to understand significant amounts of conversational speech using the prosthesis without the aid of lipreading. These results are usually obtained under ideal acoustic conditions but, unfortunately, the environments in which the prostheses are most often used are rarely perfect. Some form of competing signal is always present in the urban setting, from other conversations, radio and television, appliances, traffic noise and so on. As might be expected, implant users in general find background noise to be the largest detrimental factor in their understanding of speech, both with and without the aid of lipreading. Recently, some assessment of implant patient performance with competing noise has been attempted using a four-alternative forced-choice spondee test (1) at Iowa University. Similar testing has been carried out at the University of Melbourne with a group of patients using the Nucleus multichannel cochlear prosthesis. This study formed part of an assessment of a two formant (F0/FI/F2) speech coding strategy (2). Results suggested that the new scheme provided improved speech recognition both in quiet and with competing noise. This paper reports on some more detailed investigations into the effects of background noise on speech recognition for multichannel cochlear implant users.
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    Speech recognition abilities in profoundly deafened adults using the Nucleus 22 Channel Cochlear Implant System
    Brimacombe, J. A. ; Webb, R. L. ; Dowell, R. C. ; Mecklenburg, D. J. ; Beiter, A. L. ; Barker, M. J. ; Clark, Graeme M. ( 1987)
    Research in the area of cochlear prostheses to restore a level of hearing sensation to the profoundly deaf has been ongoing at a number of centers throughout the world since the 1960's. 3, 4, 7, 8,. Work on a multichannel cochlear implant that utilizes a speech feature extraction coding strategy and multi-sited, sequential, bipolar stimulation to enhance pitch perception began at the University of Melbourne under the direction of Professor Graeme Clark in the 1970's. Collaboration with Nucleus Limited, a multi-national biomedical corporation from Australia, led to the development of the current version of the prosthesis. The Nucleus 22 Channel Cochlear Implant System has been described in detail elsewhere. 1, 5
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    Speech processing for electrical stimulation of the auditory nerve
    Miller, J. B. ; Tong, Y. C. ; Blamey, P. J. ; Clark, Graeme M. ; Dowell, R. C. ; Seligman, P. M. ( 1986)
    The development of cochlear prostheses which provide hearing .sensation to those previously totally deaf by means of electro-neural stimulation has brought new hope for normal communication to a portion of the deaf community that had previously been beyond help by conventional hearing aids. A cochlear prosthesis provide hearing sensation by exciting nerve fibres in the auditory nerve using small electrical current passed through one or more electrode placed in or around the cochlea. Once this artificial link in the auditory information pathway has been established there still remain considerable challenge in the selection of appropriate coding of information to be transmitted along it. In this paper we consider the design of signal processing necessary for an effective speech perception, prosthesis via the electrical stimulation of the auditory nerve.
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    A formant-estimating speech processor for cochlear implant patients
    Blamey, P. J. ; Dowell, R. C. ; Brown, A. M. ; Seligman, P. M. ; Clark, Graeme M. (Speech Science and Technology Conference, 1986)
    A simple formant-estimating speech processor has been developed to make use of the "hearing" produced by electrical stimulation of the auditory nerve with a multiple-channel cochlear implant. Thirteen implant patients were trained and evaluated with a processor that presented the second formant frequency, fundamental frequency, and amplitude envelope of the speech. Nine patients were trained and evaluated with a processor that presented the first formant frequency and amplitude as well. The second group performed significantly better in discrimination tasks and word and sentence recognition through hearing alone. The second group also showed a significantly greater improvement when hearing and lipreading was compared with lipreading alone in a speech tracking task.
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    Rehabilitation for multiple-channel cochlear prosthesis patients
    Martin, L. F. ; Dowell, R. C. ; Brown, A. M. ; Clark, Graeme M. (Raven Press, 1985)
    The postoperative program for multiple-channel cochlear prosthesis patients can be divided into four main areas: 1) Psychophysical evaluation is carried out to optimize the patient's speech processor for their individual needs, Measurements required include threshold, dynamic range and pitch ranking for each of the implanted electrodes. 2) Counselling is very important to ensure patients are able to effectively operate their speech processor and that they are aware of factors in the environment which may affect performance (e.g., noise). 3) Auditory training and training in conjunction with lipreading for tasks grading from simple (e.g., discrimination of word length) to more difficult (e.g. consonant discrimination) is of benefit in making patients aware of their capabilities with the prosthesis and helping them to improve communication skills. However, highly specific training (e.g., closed set vocabulary) does not seem to be of general benefit to patients. Speech tracking provides a training procedure relevant to normal communication but has some limitations due to the degree of familiarity reached with a particular speaker. 4) Assessment of patients is carried out at this stage in great detail as it is necessary to collect data about the effectiveness of cochlear implants and also to provide information about possible improvements to speech processing strategies and external hardware. The amount of assessment required will decline as the procedure becomes established, but some investigation will continue to be necessary.
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    Psychophysics of multiple-channel stimulation
    Dowell, R. C. ; Tong, Yit. C. ; Blamey, P. J. ; Clark, Graeme M. (Raven Press, 1985)
    Eight patients implanted with multiple-channel cochlear prostheses have displayed good discrimination of sound sensations elicited at different sites within the cochlea. All patients rank the sensations from "sharp" to "dull" in an order which corresponds with basal to apical position in the cochlea. Detailed psychophysical studies have been carried out on two patients. These showed that discrimination of rate of (pulsatile) stimulation is good for frequencies up to 300 Hz and falls off sharply for frequencies above this. Electrode transitions (changes in position along the cochlea) are well discriminated for fast changes (25 msec), whereas rate transitions are not well discriminated for changes faster than 100 msec. From these results a speech processing strategy was formulated where second formant information is mapped to position in the cochlea and fundamental frequency mapped to rate of stimulation. Vowel and consonant confusion studies show consistent results for all patients using this processing strategy. A study involving two electrode stimuli demonstrated the possibility of presenting first formant information in addition to the second formant and fundamental frequency.
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    Patient results for a multiple-channel cochlear prosthesis
    Dowell, R. C. ; Brown, A. M. ; Shepherd, R. K ; Clark, Graeme M. (Raven Press, 1985)
    Six patients implanted with multiple-channel cochlear prostheses and using take-home, wearable speech processors, were assessed three months postoperatively using the Minimal Auditory Capabilities (MAC) battery. Results showed statistically significant improvement on virtually all tests over their preoperative performance with a hearing aid. Four patients showed significant results for open set speech testing. Lipreading tests, using word and sentence material, showed significant improvement for all patients when the cochlear prosthesis was used with lipreading compared to lipreading alone. All the above tests were carried out without training with recorded material of an unfamiliar speaker. Improvements in communication speed of 55% to 126% over lipreading alone were obtained for the six patients as assessed by the speech tracking procedure. These results are for scores averaged over eight sessions of tracking with the two conditions (with and without cochlear prosthesis). The order of conditions was alternated at each session to control practice effects. The wearable speech processor is used all day every day by five patients, and four hours a day by one patient. Reported benefit is not only for communication but also for the recognition of environmental sounds. Four patients have attempted using the telephone with some success in a restricted context situation. One patient uses the telephone routinely without using any special coding strategies. Reported problems with the cochlear prosthesis are primarily related to background noise. Results for these six patients are consistent with those obtained for two patients implanted with a prototype multiple-channel prosthesis in 1978-1979.